Care Home: Belchford

What the care home does well People have their needs assessed before they are offered an opportunity to live at the home. People can visit the home so that they can see if they like it. Peoples` individual needs and choices are taken into account when support plans are written. We were told "The service gives a high level of care and takes into account the needs of the individual. They look at people as individuals." People living at the home are supported to live the life they choose and to remain healthy and have their health needs met. Complaints and concerns are responded to and the staff at the home try to put things right. There are enough staff on duty to make sure that people can do the things they want to do. We were told "We can do more now we have more staff." The home has a clear management structure in place and good records are kept of how the home is managed for the benefit of the people who live there. What has improved since the last inspection? A portable hoist has been purchased and staff have been trained how to use it. What the care home could do better: People living at the home should have a contract that includes the fees they are expected to pay for the service they receive. The home should have its own computer so that staff do not have to produce work documents on their personal lap top equipment. This would ensure that the home is compliant with the Data Protection Act 1998. Staff should be offered training in the nutritional needs of younger adults to help them plan menus. Furniture with torn upholstery should be replaced. Some of the soft furnishings in the home should be replaced as they are looking shabby. The home should be decorated so that it looks nice and clean. The shower head should be replaced and the kitchen repairs should be carried out as soon as possible. The new manager should register with the Care Quality Commission and start the registered managers award as soon as practicable. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Belchford Hesleden Road Hesleden, Blackhall Hartlepool TS27 4PB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jean Pegg     Date: 2 0 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Belchford Hesleden Road Hesleden, Blackhall Hartlepool TS27 4PB 01429836286 F/P01429836286 Telephone number: Fax number: Email address: Provider web address: www.milburycare.com Name of registered provider(s): Type of registration: Number of places registered: Milbury Care Services Ltd care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 7 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning disability Code LD, maximum number of places: 7 Date of last inspection Brief description of the care home Belchford provides residential care for up to seven people who have a learning disability. The home is a detached house with large grounds, in a rural setting. The centres of Durham and Peterlee are easily accessible by car. The home is run by Milbury Care Services Limited, an organisation that specialises in services for people with a learning disability. From information provided by the home, the current scale of charges ranges from one thousand two hundred pounds and one thousand six hundred and thirty three pounds per week. Additional charges between eight pounds Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 7 Brief description of the care home and twenty five pounds per week are made as a contribution towards the homes car. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last time this home had an inspection visit was 24 May 2007. In 2008 the home had an annual service review instead of a full inspection visit. This was because it had been rated as a good service. This inspection visit was carried out on 20 May 2009 by one inspector who spent six hours in the home. Information used in this report came from a variety of sources including observations made during our visit on 20 May 2009, an annual quality assurance assessment document that was completed by the manager and sent in to us before we visited the home, surveys that were returned to us by three health and social care professionals that use the service and one member of staff. We also spoke to the people who live and work at the home when we visited. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 Care Homes for Adults (18-65 years) Page 7 of 27 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs assessed before they are offered a place at the home. Trial visits are encouraged so that people can see if they like the home and what it can offer them. Evidence: We looked at the file of the last person to be admitted to the home. We found that there were records showing pre-admission visits to the home. We also saw that a range of different assessments had been completed. Support plans about how to care for the person had been developed from the different assessments. We also saw evidence of the local authority having reviewed the persons care at the home. We noted that the person had been provided with a contract detailing the terms and conditions of residency, however, the contract did not state the fees that should be paid each week. The staff survey that we received indicated that they were always given up to date information about the needs of the people they care for. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed support plans are produced for each person that guide staff in how to meet individual care needs. The practices for recording the support plans is not good and may be in breach of the Data Protection Act 1998. Evidence: We looked at one persons care plan that had been written in the new company format. We found that the plans were quite detailed and covered a range of different needs. The key worker reviews the plans on a regular basis. One of the care managers who returned surveys to us said The service gives a high level of care and takes into account the needs of the individual. They look at people as individuals. They access the community as much as they can. We saw that people had support plans in place in relation to their ability to make decisions. Some people had advocates appointed. We spoke to one advocate who told us that people really developed in this home and that the care provided was excellent. They told us This is a really excellent place. Look beyond the building. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: They have good results. My clients that are here come on. Risk assessments were in place for each person covering a range of different activities. One care manager told us The care team are aware of individual needs in relation to the needs of others. One individual in his care plan and risk assessment is not allowed to impose his own demands on others who are more vulnerable. We noticed that the support plans were word processed and that the home did not have any word processing equipment in place, only a printer. We asked how the home were able to produce these documents without any equipment. We were told that the homes computer was broken and that staff brought in their personal lap tops to work on. We were told that memory sticks were used to download templates and that information was erased once the support plans had been printed. This is not good practice and could be in breach of the Data Protection Act 1998. We said that if the organisation expected these personal support plans to be word processed then they should provide the appropriate equipment that is complaint with Data Protection Act 1998 principles, for staff to use. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are helped to lead a life that is suited to their needs and wishes and keeps them involved in the local community so that they can continue to develop their skills and relationships. Evidence: From what we saw during our visit and from what we were told by people who know the service, it was clear that people living at the home are given lots of opportunities to maintain and develop their skills. For example. We were told The two people I know at Belchford each have a need for careful management. They are supported to keep in touch with family and to personalize their rooms and to take part in activities of their choice. One was helped to make his own use of the large garden area by creating his own summerhouse. We were also told how one person used to go to the local college to do living skills. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: We were given examples of how the people living at the home participate in the local community for example visiting local shops where they are known by name. The activities coordinator told us that they make sure that everyone goes out for a meal at least once a week. We were also told about trips to a disco in Hartlepool and visits to other care homes for people to meet their friends and socialise. The home has its own vehicle but will also use public transport to get people out into the community. One care manager told us The service gives a high level of care and takes into account the needs of the individual. They look at people as individuals. They access the community as much as they can. During our visit some of the people living at the home were out with staff for part of the day. What the staff told us about activities in the home was confirmed by what we saw. Each person has an activity plan that shows what they will be doing each day. This plan is backed up by a diary that shows what they actually did and whether or not they enjoyed the experience. We were told by one care manager Activities are used in accordance with residents wishes e.g decor and equipment. We were told about the holidays that people have ranging from day trips to five day holidays. From what we saw, the routines in the home are fairly relaxed and people were treated with respect. We were shown a pictorial menu that is used with the people who live at the home. We were told that staff and the people who live at the home plan the menus which rotate every four weeks. We looked in the food cupboards and freezers and saw that there were plenty of different foods available for people. The day we visited people were having buns for lunch with meat and salad in them. People sat at their own tables and ate at their own pace. Cups of tea and coffee were served throughout the day. We were told that only the new staff recruited to the home had not completed their food hygiene course but that they were completing their introductory training programme. We suggested that staff might benefit from some training in nutrition to help them plan menus. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are given support to help meet their personal and health care needs. Other health care professionals provide advice and support and medication is managed appropriately. Evidence: Individual support plans describe the level of support that each person is to receive. Equipment is provided for those that need it and staff have been trained to use it. Each person has an O.K. Health Check document completed by a community psychiatric nurse which is then reviewed by the local general practitioner. This is done each year to make sure that peoples health needs are reviewed and responded to on a regular basis. The health care professional that returned a survey to us indicated that the care service always seek advice and act upon the advice to manage and improve individual health needs and that health needs are always met by the care service. We have received one notification about the incorrect dosage of medication being administered to someone. The appropriate actions were taken by staff to ensure the safety of the person. We observed the administration of medicines during our visit and Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: found it to be satisfactory. We did note that the records held about medication in the persons support plan did not match the medicines recorded on the Medicines Administration Records sheet. The manager said that this would be rectified straight away. We were told that a new medicines fridge was on order. We were told by a care manager Yes Belchford is clear about use of medication. Clinical appointments are kept. Service users are helped to take medication. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are responded to and procedures and training are in place to protect people living at the home. Evidence: Both of the care manager surveys indicated that the home always respond appropriately if concerns are raised. The home has a pictorial complaints procedure which is used to help explain what people should do if they have a concern about something. During the last twelve months the home has received one complaint. This complaint was about the state of the internal environment. This was investigated by Durham County Council who gave them an action plan to put things right. The home had responded to the complainant saying that they had already identified the need to improve certain areas of the home and that this would be done by the end of May 2009. Adult protection procedures are in place and there have been no adult protection referrals made. Staff have received training in safeguarding adults. Care Homes for Adults (18-65 years) Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment that people live in is generally clean but it is not in a good state of repair or decoration. Evidence: The home received a complaint about the state of the internal environment in January 2009. This complaint was investigated by the local authority who recommended that action be taken to monitor the central heating system which has been done and to paint and repair the damage to wall coverings and to clean or replace the floor coverings. The repairs have been done and decoration and replacement of the floor coverings is planned to take place soon. During our visit we noticed that in addition to the replacement of flooring and decoration there is a need to audit the internal furnishings. We saw things like torn upholstery on chairs, which could present a fire hazard, dirty and frayed voile curtains hanging at the windows, dried blood on a mattress, washed out bath mats and shabby light shades. In the bathroom, a shower head was held together with elastic bands and the bath hoist seat was badly discoloured. We also saw that natural light was being blocked in the upstairs bathroom by ivy that was growing across the window. The kitchen also needed some repairs including a new drawer and work top where the surface had become chipped. In general, the state of the environment was poor and in need of some investment to update and renew most of the furnishings and fabric within it. Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: The home did have reasonable laundry facilities and there was some evidence of good practice in the way cleaning products were stored and cleaning rotas were operated. Colour coded systems were used for cleaning appliances and liquid soap was available to use. Care Homes for Adults (18-65 years) Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home benefit from a team of staff that have been recruited properly and provided with training that enables them to do their jobs. Evidence: Thirteen of the seventeen staff employed at the home have attained National Vocational Qualifications in Care at level two or above. The remaining staff will be encouraged to complete the award when they have completed their induction and probationary period. The staff survey we received, told us that they were provided with training that was relevant to their role and that helped them to meet the individual needs of the service users. The home has recently recruited more staff to join the care team. The staff we spoke to saw this as a benefit saying they could do a lot more now we have more staff. There was sufficient staff on duty the day we visited. We saw that people were able to take part in individual activities both inside and outside of the home. We looked at three staff recruitment files and saw that the central human resources department had sent written confirmation to the manager to say that the correct preemployment checks had been carried out for each person. An induction checklist had been completed for each person. The staff that we spoke to confirmed that they had Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: been taken through a thorough recruitment process. I had my interview, completed an application form and had checks made. And I was satisfied with the training I had. I was shown around and met people. The first week I looked at support plans. The staff we spoke to were happy with the training they had received. We were shown a training and development file that shows what training each person has done including copies of certificates gained. This training included infection control and the mental capacity act. A lot of training is delivered electronically via the EL box that is available for staff to use. This use can be monitored and tracked by managers. The EL box includes training information for the company induction package, care standards, food hygiene, infection control, health and safety, fire, Protection Of Vulnerable Adults and medicines awareness. Specialist training to do with epilepsy, non crisis interventions, autism, diabetes etc. is also provided to staff. We were told Training is quite good, all my mandatory training has been completed and I have National Vocational Qualifications at level two and three. The staff supervision time table was seen and was up to date. The supervision sessions were structured and covered a range of different topics. Staff told us that they received regular supervision. Care Homes for Adults (18-65 years) Page 21 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home is generally very good and supportive of the people who live at the home. Evidence: The home has a new manager who has been seconded into the post for six months. The manager has worked for the organisation for twelve years. She has a National Vocational Qualification in Care at level three and plans to commence the registered managers award in September 2009. She has completed her manager induction programme. This is her first manager position. She told us that she intends to register with the Care Quality Commission as soon as possible. We asked to see evidence of how the home seeks views from other people so that they can monitor the quality of the service they provide. We were shown copies of the regulation 26 reports which they are required to produce each month. We were also told that annual service reviews are sent out to general practitioners, care managers and relatives. Each key worker also reviews individual support plans for the people they care for each month. We were also shown the weekly checks that are carried out Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: in the home for example medicines and health and safety checks. As stated earlier in this report, we were not happy with the arrangements for producing support plans which meant that staff were using personal lap tops to write them. We do not believe that this practice complies with the Data Protection Act 1998 and have recommended that this area be looked at. We were told that the Environmental Health Officer last visited the home on 7 November 2007 and the Fire Officer on 11 December 2008. We were told that no requirements were made. We were shown the files that hold the records of maintenance contracts and checks for the home. They were all in order. Staff confirmed that they had plenty of protective equipment and clothing to use to do their jobs safely. Care Homes for Adults (18-65 years) Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 24 23 The care home must be kept 01/07/2009 in a good state of repair both internally and externally. This will ensure that people live in a home that is well maintained and cared for. 2 24 23 Equipment and facilities that 01/07/2009 are provided at the care home must be maintained in good working order. For example the shower head in the bathroom and the kitchen fixtures and fittings should be repaired. This will ensure that people living at the home can safely use the equipment provided. Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 5 10 Individual contracts should state the fees that will be charged to that person. The registered person should review the system of staff Page 25 of 27 Care Homes for Adults (18-65 years) Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations recording service user support plans on personal lap tops to ensure compliance with the Data Protection Act 1998. 3 10 The broken computer that belongs to the home should be replaced so that staff do not have to use their personal lap tops to produce service user support plans. Staff should be offered training in nutritional needs of younger adults to ensure that menus are well balanced and suited to the needs of the people who live at the home. Chairs that have upholstery that is split or torn should be taken out of use to prevent them from becoming a fire hazard. Each room in the home should be audited to identify all furniture and soft furnishings that need to be renewed or replaced. The internal decoration and fittings should be brought up to a good standard and that standard should be maintained so that people live in a nice environment. The new manager should commence the registered managers award as soon as possible. The new manager should register with the Care Quality Commission as soon as practicable. Support plans should be produced and maintained in accordance with the Data Protection Act 1998. 4 17 5 24 6 24 7 24 8 9 10 37 37 41 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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